Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Analysis of setup error at rectal cancer radiotherapy technique

직장암 방사선치료기법별 자세오차에 관한 분석

  • Kim, Jeong-Ho (Department of Radiation Oncology, Konyang University Hospital) ;
  • Bae, Seok-Hwan (Division of Radiology, Konyang University) ;
  • Kim, Ki-Jin (Department of Nuclear Medicine, Konyang University Hospital) ;
  • Yu, Se-Jong (Department of Radiology, Konyang University Hospital) ;
  • Kim, Jee-Yoon (Hyejeon College, Dept. of Nursing)
  • 김정호 (건양대학교병원 방사선종양학과) ;
  • 배석환 (건양대학교 방사선학과) ;
  • 김기진 (건양대학교병원 핵의학과) ;
  • 유세종 (건양대학교병원 영상의학과) ;
  • 김지윤 (혜전대학교 간호학과)
  • Received : 2013.10.23
  • Accepted : 2013.12.05
  • Published : 2013.12.31
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Abstract

Radiotherapy of rectal cancer requires a stabilized image but the movement of patients is almost unavoidable in radiotherapy. In this study, the setup error using the radiation treatment technique was compared according to the loading time and BMI(Body Mass Index) for 14 patients with rectal cancer. In addition, the variation of the dose by the average setup error was compared. Therefore, the technique of a selective standard was established. As a result, 3DCRT(3-Dimensional Radiation Therapy) and VMAT(Volumetric Modulated Arc Therapy) showed a similar time and error. In comparison, IMRT(Intensity Modulated Radiation Therapy) increased the time two fold and the error four fold. In BMI, a more pyknic patient showed a larger error for all techniques. Regarding the dose, IMRT and VMAT increased much more than 3DCRT in the average error at the small bowel. Therefore, 3DCRT of the short time will be applied to pyknic rectal cancer. Moreover, VMAT selects than IMRT in the overexposure of the small bowel.

직장암의 방사선치료는 정지된 영상을 이용하였다. 하지만 방사선치료 시 환자의 움직임이 발생된다. 이에 직장암 환자 14명을 대상으로 치료시간과 체형에 따른 기법별 자세오차를 비교하고자 하였다. 또한 평균오차에 대한 기법별 선량학적 변화량을 비교하였다. 비교를 통해 치료기법 선택의 기준을 마련하고자 하였다. 측정결과 3DCRT와 VMAT은 치료시간 및 자세오차가 비슷하였다. 이에 비해 IMRT는 치료시간이 약 2배, 자세오차는 약 4배 증가하였다. 체형에서는 비만형일수록 모든 치료기법에서 자세오차가 증가하였다. 선량평가에서는 소장측면에서는 동일한 오차에 대해 IMRT와 VMAT이 3DCRT에 비해 큰 폭의 선량증가를 보였다. 따라서 비만형인 직장암 환자의 경우 치료시간이 짧은 3DCRT를 적용하여야 한다. 소장의 피폭이 많을 경우에는 IMRT보다는 VMAT을 선택하여야 한다.

Keywords

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